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General NPI Number Information
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NPI Number | 1003378035
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Entity Type | Individual
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Provider Name | KIMBERLY SARAH TAY
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Gender | Female
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Dates
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Enumeration Date | 03/31/2019
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 6525 W SACK DR STE 201
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City | GLENDALE
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State | AZ
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Zip | 85308-7106
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Country | US
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Telephone | 602-337-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 11100 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 75095
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License Number State | AZ
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